Properties of crosslinked ultra-high-molecular-weight polyethylene

TiNbSn stems with gradient changes of Young's modulus and stiffness reduce stress shielding compared to the standard fit-and-fill stems

BACKGROUND

The difference between Young's moduli of the femur and the stem causes stress shielding (SS). TiNbSn (TNS) stem has a low Young's modulus and strength with gradient functional properties during the change in elastic modulus with heat treatment. The aim of this study was to investigate the inhibitory effect of TNS stems on SS and their clinical outcomes compared to conventional stems.

METHODS

This study was a clinical trial. Primary THA was performed using a TNS stem from April 2016 to September 2017 for patients in the TNS group. Unilateral THA was performed using a Ti6Al4V alloy stem from January 2007 to February 2011 for patients in the control group. The TNS and Ti6Al4V stems were matched in shape. Radiographs were obtained at the 1- and 3-year follow-ups. Two surgeons independently checked the SS grade and appearance of cortical hypertrophy (CH). The Japanese Orthopaedic Association (JOA) scores before and 1 year after surgery were assessed as clinical scores.

RESULTS

None of the patients in the TNS group had grade 3 or 4 SS. In contrast, in the control group, 24% and 40% of patients had grade 3 and 4 SS at the 1- and 3-year follow-ups, respectively. The SS grade was lower in the TNS group than in the control group at the 1- and 3-year follow-ups (p < 0.001). The frequencies of CH in both groups were no significant difference at the 1- and 3-year follow-ups. The JOA scores of the TNS group significantly improved at 1 year after surgery and were comparable to control group.

CONCLUSION

The TNS stem reduced SS at 1 and 3 years after THA compared to the proximal-engaging cementless stem, although the shapes of the stems matched. The TNS stem could reduce SS, stem loosening, and periprosthetic fractures.

TRIAL REGISTRATION

Current Controlled Trials. ISRCTN21241251. https://www.isrctn.com/search?q=21241251 . The date of registration was October 26, 2021. Retrospectively registered.

An automated system for polymer wear debris analysis in total disc arthroplasty using convolution neural network

Introduction: Polymer wear debris is one of the major concerns in total joint replacements due to wear-induced biological reactions which can lead to osteolysis and joint failure. The wear-induced biological reactions depend on the wear volume, shape and size of the wear debris and their volumetric concentration. The study of wear particles is crucial in analysing the failure modes of the total joint replacements to ensure improved designs and materials are introduced for the next generation of devices. Existing methods of wear debris analysis follow a traditional approach of computer-aided manual identification and segmentation of wear debris which encounters problems such as significant manual effort, time consumption, low accuracy due to user errors and biases, and overall lack of insight into the wear regime. Methods: This study proposes an automatic particle segmentation algorithm using adaptive thresholding followed by classification using Convolution Neural Network (CNN) to classify ultra-high molecular weight polyethylene polymer wear debris generated from total disc replacements tested in a spine simulator. A CNN takes object pixels as numeric input and uses convolution operations to create feature maps which are used to classify objects. Results: Classification accuracies of up to 96.49% were achieved for the identification of wear particles. Particle characteristics such as shape, size and area were estimated to generate size and volumetric distribution graphs. Discussion: The use of computer algorithms and CNN facilitates the analysis of a wider range of wear debris with complex characteristics with significantly fewer resources which results in robust size and volume distribution graphs for the estimation of the osteolytic potential of devices using functional biological activity estimates.

Analysis of Stress Relaxation in Bulk and Porous Ultra-High Molecular Weight Polyethylene (UHMWPE)

The reported study was devoted to the investigation of viscoelastic behavior for solid and porous ultra-high molecular weight polyethylene (UHMWPE) under compression. The obtained experimental stress curves were interpreted using a two-term Prony series to represent the superposition of two coexisting activation processes corresponding to long molecular (~160 s) and short structural (~20 s) time scales, respectively, leading to good statistical correlation with the observations. In the case of porous polymer, the internal strain redistribution during relaxation was quantified using digital image correlation (DIC) analysis. The strongly inhomogeneous deformation of the porous polymer was found not to affect the relaxation times. To illustrate the possibility of generalizing the results to three dimensions, X-ray tomography was used to examine the porous structure relaxation at the macro- and micro-scale levels. DIC analysis revealed positive correlation between the applied force and relative density. The apparent stiffness variation for UHMWPE foams with mixed open and closed cells was described using a newly proposed three-term expression. Furthermore, in situ tensile loading and X-ray scattering study was applied for isotropic solid UHMWPE specimens to investigate the evolution of internal structure and orientation during drawing and stress relaxation in another loading mode.

How does asymmetric tibial insert affect tibiofemoral kinematics and contact stresses in total knee Arthroplasty?

BACKGROUND

Asymmetric tibial insert design is expected to restore normal knee kinematics better than symmetric design. A tri-condylar implant has asymmetric and symmetric tibial inserts with a ball-and-socket joint to replace the post-cam mechanism. The purpose of this study was to compare the knee kinematics of the two designs and to measure tibiofemoral contact stresses, including that of the ball-and-socket joint.

METHODS

Using a computer simulation, the anteroposterior position and axial rotation of the femoral component were simulated during a weight-bearing deep knee bend for six validated models. Contact forces were simultaneously simulated in the medial, lateral, and ball-and-socket compartments. The relative position and the magnitude and direction of each contact force were applied to aforce/displacement control knee simulator. The contact stresses were measured individually using a pressure sensor.

RESULTS

The asymmetric tibial insert demonstrated a more posterior position of the femoral component in the lateral compartment during the entire range of motion and greater external rotation of the femoral component, compared to the symmetrical tibial insert. The mean peak contact stress of the medial and lateral compartments was < 9 Mpa, with no significant differences between the two designs except at 0°. The contact stress of the ball-and-socket joint was < 5 MPa.

CONCLUSIONS

Asymmetry of the tibial insert shows significant kinematic difference and has little influence on the peak contact stress, which is considerably lower than the yield strength of polyethylene. The asymmetric tibial insert can lead to clinical benefits owing to its kinematic and kinetic properties.

Early failure of a highly cross-linked polyethylene inlay after total hip arthroplasty probably due to insufficient irradiation

Highly cross-linked polyethylene (XLPE) is a major advance in total hip arthroplasty (THA), as it suffers from less wear and thus is associated with lower revision rates than standard ultra-high molecular weight polyethylene. Early failures are reported rarely, and associated with specific design or manufacturing issues. We report a case requiring early revision due to adverse reaction to polyethylene particles. Investigations identified insufficient irradiation as the most probable cause of failure. Here are reported the features of a clinical case with determination of the material properties of the retrieved XLPE liner and establishment of the appropriate calibration curves as reference. Periprosthetic joint infection could be ruled out with appropriate sampling as cause for the inflammatory periarticular tumour. Histology identified a massive macrophagic reaction to micrometric polyethylene particles. No component malposition was present, nor any third-body wear. The trans-vinylene index (TVI) indicated insufficient and potentially detrimental irradiation of the polyethylene, while gel content, crystallinity, melting temperature and oxidation index remained within expected ranges. Histologically proven failure of a XLPE THA liner was identifiable despite correct implantation of the components. The cause of failure most probably was an inadequate irradiation, as indicated by determination of the TVI. This case underscores the importance of histologic workup even in aseptic revisions, and of detailed analysis of retrievals. The calibration curves provided are essential for analysis of other retrievals.

Characterization of In Vivo Damage on Retrieved Total Shoulder Glenoid Liners

An attempt was made to retrieve glenoid liners from revision surgery to undertake a retrospective study to measure the resulting in vivo damage. Since the glenoid liners are circumferential, the curvature changes at every point in the component, an “assisting arm” was designed to hold the liner firmly, thus allowing accurate microscopic measurements. We characterized the damage in terms of pitting, embedded debris, complete fracture, abrasion, deformation, delamination, burnishing, grooving, and scratching that took place mutually exclusively. This study of 26 liners showed embedded debris was the most underrated damage mode found on the liners, followed by pitting and abrasion, representing 65.2% and 52.2% of the liners, respectively. The prevalence of pitting in over half the samples examined is indicative of free-radical oxidation, resulting in a decrease in physical strength from morphological changes in the microstructure. These may initiate from different pathways, however, they may interact with other processes in which other damage initiates and grows, resulting in higher damage causing premature failure due to wear. A probabilistic approach was developed to generate survival time for these liners and may provide a statistical removal time of the glenoid liners in the future.

Pit organ-based infrared discrimination sensitivity and signal transduction in the Burmese python (Python molurus bivitattus)

Burmese pythons (Python molurus bivitattus) use a unique infrared (IR) targeting system to acquire prey, avoid predators and seek thermoregulatory sites through detection of IR energy in the environment. Previous studies of sensitivity of the python IR system that relied on analysis of complex, natural behaviors lacked robust, reliable responses in animals habituated to experiments, and in vitro electrophysiological study failed to test behavioral function of the implicated protein thermoreceptor, TRPA1. The present study used conditioned discrimination procedures to analyze behavioral sensitivity and signal transduction in the python IR system. Pythons trained to behaviorally discriminate thermal stimuli averaged 70% correct choices, but failed to make correct choices when pit organs were physically occluded with IR-blocking material. The pythons exhibited greater sensitivity to thermal stimuli than previously reported, evident by correct choices that exceeded chance in response to a 14×10^-6Wcm^-2 irradiance contrast, or 0.5°C thermal differential. Finally, in a test of the behavioral role of the putative thermoreceptor protein TRPA1, despite pit organ treatment with a TRPA1 inhibitor, python performance exceeded chance and was similar to baseline discrimination and control trials. Collectively, the results suggest that the IR system is a high sensitivity, broad-spectrum thermosensor that may operate through different and/or multiple thermoreceptive proteins with overlapping spectral response profiles. The findings reported here provide a better understanding of the relationship between the brain, behavior and environment in driving survival and ecological success of the Burmese python, especially as an invasive megapredator in the southern United States.

Aseptic and septic prosthetic joint loosening: Impact of biomaterial wear on immune cell function, inflammation, and infection

The success of total joint replacements has led to consistent growth in the use of arthroplasty in progressively younger patients. However, more than 10 percent of patients require revision surgeries due to implant failure caused by osteolytic loosening. These failures are classified as either aseptic or septic and are associated with the presence of particulate wear debris generated by mechanical action between implant components. Aseptic loosening results from chronic inflammation caused by activation of resident immune cells in contact with implant wear debris. In contrast, septic loosening is defined by the presence of chronic infection at the implant site. However, recent findings suggest that subclinical biofilms may be overlooked when evaluating the cause of implant failure, leading to a misdiagnosis of aseptic loosening. Many of the inflammatory pathways contributing to periprosthetic joint infections are also involved in bone remodeling and resorption. In particular, wear debris is increasingly implicated in the inhibition of the innate and adaptive immune response to resolve an infection or prevent hematogenous spread. This review examines the interconnectivity of wear particle- and infection-associated mechanisms of implant loosening, as well as biomaterials-based strategies to combat infection-related osteolysis.

Gamma Rays Induced Modification in Ultrahigh Molecular Weight Polyethylene (UHMWPE)

Modifications taking place in ultrahigh molecular weight polyethylene (UHMWPE) films due to gamma ray radiation-induced and investigated in correlation with the applied doses. Films were irradiated in a vacuum at room temperature by a 1.25 MeV Co60 a source with doses ranging from 0 to 300 kGg. The optical, chemical, structural, and surface morphological properties of the irradiated and unirradiated UHMWPE films were investigated by UV-Visible, FTIR, XRD, and SEM, respectively. The band gap $E_g$ decreases with increasing radiation dose and coloration effects have been seen at higher doses. FTIR spectra show an oscillatory behavior in the transmittance intensities without affecting in their peak positions. Number of small absorption peaks can be seen clearly which may be due to the cross-linking of the polymeric chain. No significant change in crystalline peak has been found in the X-ray diffraction pattern indicating the structural stability of the polymer. The morphology of the smooth topography of the polymer samples to change rougher one polymeric sample shows the formation of microvoids on the surface of the polymeric materials with the increase of the doses from 0 to 300 kGy.

BIOMECHANICAL ASSESSMENT OF WEAR IN CERAMIC ON CERAMIC AND CERAMIC ON XLPE THAs

Total Hip Arthroplasty (THA) is an effective treatment for severe hip arthritis, with patients reporting high rates of satisfactory results postoperatively. There are a variety of choices regarding THA implant designs. Ceramic on Ceramic and Ceramic on Highly Cross-Linked Polyethylene (XLPE) THAs are the materials of choice nowadays. The purpose of this study is to review the effect of kinematics and kinetics on wear (in vivo and in vitro testing) that affect wear in Ceramic on Ceramic and Ceramic on XLPE total hip arthroplasties and identify possible advantages amongst them. The study hypothesis was that THA kinematics and/or kinetics, since they directly affect THA wear, could provide data for possible advantages between the examined implant designs. A systematic review of the literature identified no significant evidence for biomechanical advantages between these two prostheses in terms of wear. Further research is proposed with the use of gait analysis systems combined with surface electromyography to further investigate THA biomechanics at a laboratory set up. Wearable sensors technology could also identify detailed biomechanical parameters in more complex daily activities.

Recent Advances in UHMWPE/UHMWPE Nanocomposite/UHMWPE Hybrid Nanocomposite Polymer Coatings for Tribological Applications: A Comprehensive Review

In the recent past, polymer coatings have gained the attention of many researchers due to their low cost, their ability to be coated easily on different substrates, low friction and good anti-corrosion properties. Various polymers such as polytetrafluroethylene (PTFE), polyether ether ketone (PEEK), polymethylmethacrylate (PMMA), polyurethane (PU), polyamide (PA), epoxy and ultra-high molecular weight polytheylene (UHMWPE) have been used to develop these coatings to modify the surfaces of different components to protect them from wear and corrosion. However, among all these polymers, UHMWPE stands out as a tribologist’s polymer due to its low friction and high wear resistance. These coatings have found their way into applications ranging from microelectro mechanical systems (MEMS) to demanding tribological applications such as bearings and biomedical applications. Despite its excellent tribological properties, UHMWPE suffers from limitations such as low load bearing capacity and low thermal stability. To overcome these challenges researchers have developed various routes such as developing UHMWPE composite and hybrid composite coatings with several types of nano/micro fillers, developing composite films system and developing dual film systems. The present paper is an effort to summarize these various routes adopted by different researchers to improve the tribological performance of UHMWPE coatings.

Comparison of macro-, micro- and nanomechanical properties of clinically-relevant UHMWPE formulations

We characterized a set of eleven clinically relevant formulations of UHMWPE for total joint replacements. Although their molecular and supermolecular structure were quite similar as evidenced by IR, DSC and SAXS measurements, there were slight differences in their crystallinity (DSC crystallinity ranging from 52 to 61%), which were connected with processing conditions, such as the total radiation dose, thermal treatment and/or addition of biocompatible stabilizers. Mechanical properties were assessed at all length scales, using macroscale compression testing, non-instrumented and instrumented microindentation hardness testing (at loading forces ~500 mN), and nanoindentation hardness testing measured at both higher and lower loading (~4 mN and ~0.6 mN, respectively). In agreement with theoretical predictions, we found linear correlations between UHMWPE crystallinity and its stiffness-related properties (elastic moduli, yield stress, and hardness) at all length scales (macro-, micro- and nanoscale). Detailed statistical evaluation of our dataset showed that the accuracy and precision of the applied methods decreased in the following order: non-instrumented microindentation ≥ instrumented microindentation ≥ macromechanical properties ≥ nanoindentation measured at higher loading forces ≫ nanoindentation measured at lower loading forces. The results confirm that microindentation and nanoindentation at sufficiently high loading forces are reliable methods, suitable for UHMWPE characterization.

The Biomaterials of Total Shoulder Arthroplasty: Their Features, Function, and Effect on Outcomes

The materials that are used in total shoulder arthroplasty (TSA) implants have been carefully chosen in an attempt to minimize hardware-related complications. The 2 main metal alloys used in TSA implants are Ti-6Al-4V (titanium-aluminum-vanadium) and CoCrMo (cobalt-chromium-molybdenum). Ti alloys are softer than CoCr alloys, making them less wear-resistant and more susceptible to damage, but they have improved osseointegration and osteoconduction properties. Although controversial, metal allergy may be a concern in patients undergoing TSA and may lead to local tissue reaction and aseptic loosening. Numerous modifications to polyethylene, including cross-linking, minimizing oxidation, and vitamin E impregnation, have been developed to minimize wear and reduce complications. Alternative bearing surfaces such as ceramic and pyrolytic carbon, which have strong track records in other fields, represent promising possibilities to enhance the strength and the durability of TSA prostheses.

Influence of Irradiation Temperature on Oxidative and Network Properties of X-Ray Cross-Linked Vitamin E Stabilized UHMWPE for Hip Arthroplasty

Previous studies have shown that increased cross-link density, reduced free radicals, and increased antioxidant grafting resulting from electron-beam irradiation at elevated temperatures improved the wear performance and the oxidative stability of vitamin E blended UHMWPE. The current study explores the impact of elevated irradiation temperature on vitamin E blended UHMWPE using X-ray. We hypothesize that the effects of temperature would be similar to those observed after electron-beam irradiation due to the relatively high dose rate of X-rays. Two X-ray doses of 80 and 100 kGy and two irradiation temperatures, that is, room temperature and 100°C were considered. The reference was Vitelene®, a vitamin E stabilized polyethylene cross-linked with 80 kGy by e-beam at 100°C. Oxidation index and oxidation induction time, as well as cross-link density, gel fraction, and trans-vinylene index, were determined, as the oxidative and network properties are decisive for the long-term implant performance. Gel fraction and oxidation induction time were significantly improved subsequently to warm irradiation in comparison with the material irradiated at room temperature. In conclusion, X-ray irradiation at elevated temperatures resulted in an increase of cross-linking and oxidative resistance of vitamin E stabilized polyethylene comparable to those of e-beam irradiated UHMWPE.

Ultra-High-Molecular-Weight-Polyethylene (UHMWPE) as a Promising Polymer Material for Biomedical Applications: A Concise Review

Ultra-High Molecular Weight Polyethylene (UHMWPE) is used in biomedical applications due to its high wear-resistance, ductility, and biocompatibility. A great deal of research in recent decades has focused on further improving its mechanical and tribological performances in order to provide durable implants in patients. Several methods, including irradiation, surface modifications, and reinforcements have been employed to improve the tribological and mechanical performance of UHMWPE. The effect of these modifications on tribological and mechanical performance was discussed in this review.

Polyethylene in total knee arthroplasty: Where are we now?

Polyethylene (PE) remains the gold standard for the articulating surface in hip and knee arthroplasty. To increase arthroplasty longevity and improve wear resistance, newer versions of PE have been designed with resultantly different wear properties. Highly cross-linked polyethylene (HXLPE) is used in total hip arthroplasty with excellent outcomes; however, its use in total knee arthroplasty (TKA) remains conflicting. This review summarizes biomechanical and wear properties, clinical outcomes, and cost of polyethylene inserts in TKA. Simulation studies have convincingly shown decreased wear and oxidation rates with HXLPE when compared to conventional polyethylene (CPE). Registry results have been conflicting, and short- to midterm clinical studies have not demonstrated a significant difference between HXLPE and CPE. The cost of HXLPE inserts is higher than CPE. Long-term clinical data are lacking and further studies are warranted to evaluate the role of HXLPE in TKA.

Is Cross-Linked Polyethylene an Improvement Over Conventional Ultra-High Molecular Weight Polyethylene in Total Knee Arthroplasty?

BACKGROUND

Reducing polyethylene (PE) wear by increasing the cross-linking encouraged surgeons to hope for increased total knee arthroplasty (TKA) survival rates. Different methods of manufacturing cross-linked polyethylene (XLPE) were introduced, following promising in vitro results. Is there a measurable effect of cross-linking on TKA survival?

METHODS

A registry study was conducted, focusing on fixed tibial inserts in primary TKA. Conventional PE represented 87% of the liners, 10% were cross-linked and 2% were antioxidant PE. Sixty-four percent of the liners were posterior-stabilized (PS). Survival of the different PE groups and survival of the main XLPE available were successively compared. We also looked for differences in the same brand implant groups with regard to PE type, as well as differences between cruciate retaining and PS knees.

RESULTS

No differences were found when looking at survival for any cause or for aseptic loosening only (P = .96). When comparing the XLPE available, X3 was found to have a better survival than Prolong or Smith & Nephew XLPE (P = .036). When the same implants and X3 or conventional PE were used, no difference could reach a statistical significance. With Zimmer LPS Flex, Prolong XLPE was even associated with a lower survival compared with conventional PE. On Stryker implants, only the Cox regression model allowed highlighting a difference between X3 XLPE and conventional PE, only in PS knees.

CONCLUSION

Increasing the cross-linking seems to only have a low effect, if any, on knee arthroplasty survival. Differences between brands could be found; the manufacturing process could play a role.

Ultra-High Molecular Weight Polyethylene: Influence of the Chemical, Physical and Mechanical Properties on the Wear Behavior. A Review

Ultra-high molecular weight polyethylene (UHMWPE) is the most common bearing material in total joint arthroplasty due to its unique combination of superior mechanical properties and wear resistance over other polymers. A great deal of research in recent decades has focused on further improving its performances, in order to provide durable implants in young and active patients. From "historical", gamma-air sterilized polyethylenes, to the so-called first and second generation of highly crosslinked materials, a variety of different formulations have progressively appeared in the market. This paper reviews the structure-properties relationship of these materials, with a particular emphasis on the in vitro and in vivo wear performances, through an analysis of the existing literature.

Influence of analyzed lubricant volumes on the amount and characteristics of generated wear particles from three different types of polyethylene liner materials

The articulating components of artificial joints consist mainly of metals, ceramics, or polymers. Resulting abrasive wear particles can promote osteolysis and aseptic loosening of the endo-prosthetic implants. Ultra-high-molecular-weight-polyethylene is the material used most for bearing couples in total hip replacement. In the present study, three types of polyethylene (PE) liners varying in material composition, i.e., (1) conventional PE (C-PE), (2) sequentially cross-linked PE (SX-PE), (3) cross-linked PE blended with vitamin E (EX-PE) articulating with two types of femoral heads were used. After ultrasound treatment of each simulator lubricant, different concentrations (0.1/0.25/0.5/1.0 mL) were taken and dissolved in hydrochloric acid (37%) in a similar manner. The aim was to analyze the characteristics of wear particles generated in a hip simulator, with respect to different volumes of the lubricant. Within the scope of particle analysis, distinct alterations for particle characteristics were determined in the lubricant volumes and types of PE material used. A significant decrease in particle number for SX-PE liners, compared to the C-PE inserts and even more for EX-PE inserts, was detected at each lubricant volume. Particle morphologies varied depending on PE material. Alterations in particle size and other morphologic parameters between the four tested volumes, could be proven for each PE type. In general, particle sizes and parameters (e.g., length and width) increased with increasing serum volumes. In conclusion, the chosen volume of the simulator lubricant used for particle analysis has a crucial influence on detected particle number, size distribution, and morphologic parameters. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1299-1306, 2018.

Electron-Beam Irradiation Effect on Thermal and Mechanical Properties of Nylon-6 Nanocomposite Fibers Infused with Diamond and Diamond Coated Carbon Nanotubes

Nylon-6 is an engineering plastic with excellent properties and processability, which are essential in several industrial applications. The addition of filler such as diamond (DN) and diamond coated carbon nanotubes (CNTs) to form molded composites may increase the range of Nylon-6 applications due to the resulting increase in strength. The effects of electron-beam irradiation on these thermoplastic nanocomposites are either increase in the cross-linking or causes chain scission. In this study, DN-coated CNTs were synthesized using the sonochemical technique in the presence of cationic surfactant cetyltrimethyl ammonium bromide (CTAB). The DN-coated CNTs nanoparticles and diamond nanoparticles were then introduced into Nylon-6 polymer through a melt extrusion process to form nanocomposite fibers. They were further tested for their mechanical (Tensile) and thermal properties (thermogravimetric analysis (TGA), differential scanning calorimetry (DSC)). These composites were further exposed to the electron-beam (160[Formula: see text]kGy, 132[Formula: see text]kGy and 99[Formula: see text]kGy) irradiation using a 1.5[Formula: see text]MeV electron-beam accelerator, at room temperature, in the presence of air and tested for their thermal and mechanical properties. The best ultimate tensile strength was found to be 690[Formula: see text]MPa and 864[Formula: see text]MPa irradiated at 132 for DN/CNTs/Nylon-6 and Diamond/Nylon-6 nanocomposite fiber as compared to 346[Formula: see text]MPa and 321[Formula: see text]MPa for DN/CNTs/Nylon-6 and Diamond/Nylon-6 nanocomposite fiber without irradiation. The neat Nylon-6 tensile strength was 240[Formula: see text]MPa. These results are consistent with the activation energy calculated from TGA graphs. DSC analysis result shows that the slight increase in glass transition temperature ([Formula: see text]) and decrease in melting temperature ([Formula: see text]) which was expected from high electron-beam radiation dose.

Thin-Walled Cross-Linked Acetabular Liners Need Not Exhibit Reduced Locking Strength

Use of larger diameter femoral heads has emerged as a promising strategy to reduce the risk of dislocation after total hip arthroplasty, but thinning the walls of cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) acetabular liners to accommodate these larger heads may compromise the locking mechanism of the liner. The purpose of this study was to test the mechanical integrity of the locking mechanism in cross-linked and re-melted UHMWPE acetabular components with reduced wall thickness. The locking mechanism of cross-linked (100 kGy/re-melted) acetabular liners in sizes 50/28, 50/36, and 52/36 mm of 1 design was evaluated by lever-out tests and torsion tests. Torsion tests were performed at 2 angles to isolate the liner's locking tabs independent of the contribution of its central post. Lever-out testing demonstrated nominally reduced failure strength in 50/36-mm liners (13.3 N · m) compared with 50/28-mm liners (12.3 N · m; P=.0502), whereas the lever-out strength of 52/36-mm liners was 12.2±0.94 N · m. Failure torques were similar between 50/28- and 50/36-mm liners at 45° and 90°, but the failure torque of size 52/36-mm liners was significantly higher at each angle. The use of larger diameter femoral heads does not compromise the locking mechanism of thinned MicroSeal (Signal Medical Corp, Marysville, Michigan) acetabular liners. Use of a cross-linked UHMWPE acetabular liner, with a locking mechanism that is not compromised when the liner is thinned to a thickness of at least 2.86 mm, appears to be a biomechanically sound construct when articulated with large diameter femoral heads.

Novel artificial hip joint: A layer of alumina on Ti-6Al-4V alloy formed by micro-arc oxidation

In many hip replacement surgeries, monolithic alumina is used as a femoral head due to its high wear resistance. However, it is liable to fracture under load bearing operations in artificial joints. We propose a promising way to overcome this limitation by forming a dense alumina layer onto a relatively tough substrate such as Ti-6Al-4V alloy to obtain high wear resistance on a material that can sustain relatively high toughness. For this purpose, Al metal powders were deposited onto Ti-6Al-4V alloy by cold spraying in N2 atmosphere. Interfacial adhesion between Al and the Ti alloy was improved by the formation of a reaction layer of Al3Ti between them by heating at 640 °C for 1h in air. Subsequently, micro-arc oxidation treatment was performed to oxidize Al. The oxidized layer was composed of an outer porous layer of γ-alumina and inner-most dense layer of α-alumina. The α-alumina layer was almost fully densified and exhibited high Vickers hardness almost equal to that of alumina ceramics used as the femoral head. Thus, the newly developed dense alumina/Ti alloy can be potentially used to produce the reliable bearing surfaces of artificial hip joint.

Graphene scavenges free radicals to synergistically enhance structural properties in a gamma-irradiated polyethylene composite through enhanced interfacial interactions

A unique strategy for scavenging free radicals in situ on exposure to gamma irradiation in polyethylene (PE) nanocomposites is presented.

Contact mechanics of modular metal-on-polyethylene total hip replacement under adverse edge loading conditions

Edge loading can negatively impact the biomechanics and long-term performance of hip replacements. Although edge loading has been widely investigated for hard-on-hard articulations, limited work has been conducted for hard-on-soft combinations. The aim of the present study was to investigate edge loading and its effect on the contact mechanics of a modular metal-on-polyethylene (MoP) total hip replacement (THR). A three-dimensional finite element model was developed based on a modular MoP bearing. Different cup inclination angles and head lateral microseparation were modelled and their effect on the contact mechanics of the modular MoP hip replacement were examined. The results showed that lateral microseparation caused loading of the head on the rim of the cup, which produced substantial increases in the maximum von Mises stress in the polyethylene liner and the maximum contact pressure on both the articulating surface and backside surface of the liner. Plastic deformation of the liner was observed under both standard conditions and microseparation conditions, however, the maximum equivalent plastic strain in the liner under microseparation conditions of 2000 µm was predicted to be approximately six times that under standard conditions. The study has indicated that correct positioning the components to avoid edge loading is likely to be important clinically even for hard-on-soft bearings for THR.

Raman spectroscopic study of remelting and annealing-induced effects on microstructure and compressive deformation behavior of highly crosslinked UHMWPE for total hip arthroplasty

Three-dimensional crystallographic morphologies were studied by means of confocal/polarized Raman spectroscopy as developed upon manufacturing in three different types of first and second generation highly crosslinked UHMWPE (HXLPE) acetabular liners. The impact of such microstructural characteristics on the deformation behavior of the liners was also evaluated and discussed from the viewpoint of molecular chain mobility. All the investigated liners showed similar microstructural transitions within the first 35 μm below their surfaces in terms of crystallinity, molecular orientation, and crystalline anisotropy. Interestingly, different postirradiation heat treatments (remelting or annealing in single step or in sequential steps) led to clear differences in the subsurface microstructure among the three liners. Remelted liner possessed both lower bulk crystallinity and degree of molecular orientation as compared to the annealed liners. Sequentially, irradiated/annealed liner showed the highest degree of crystallinity and orientation among the studied liners. The peculiar microstructure of this latter liner exhibited the highest restoring (shape-recovery) force against the applied uniaxial strain. Accordingly, the present study suggests that the sequential irradiation and annealing offers an efficient way to obtain microstructure quite suitable for attaining high creep resistance. However, all the investigated liners exhibited the significantly low values of surface anisotropy, which could be equally efficient in minimizing strain-softening-assisted wear phenomena.

Comparison of one-step and sequentially irradiated ultrahigh-molecular-weight polyethylene for total joint replacements

Structure and properties of several ultrahigh-molecular-weight polyethylenes (UHMWPEs), which were crosslinked either by standard, single-step irradiation or by newer, several-step irradiation (sequential irradiation), were compared. To verify the results, the same characterization was carried out for commercially available UHMWPE liners made of sequentially irradiated polymer (X3™, Stryker, Mahwah, NJ) and one-step irradiated polymer (denoted as PE-IMC, produced by Beznoska, Kladno, Czech Republic). The structure was studied by a number of spectroscopic, diffraction, thermal, and microscopic methods. Mechanical properties were assessed by small-punch, microhardness and, wear testing. Our results suggested that sequential irradiation followed by annealing did not lead to unusual structure at the molecular or supermolecular level. Consequently, all measured mechanical properties, including wear resistance, were comparable with one-step irradiated UHMWPEs.